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* 1. Organization or Group Name

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* 2. Where is your organization or group located?

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* 3. Organization or Group Lead Contact Person 

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* 4. Organization or Group Lead Contact Person #2

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* 5. Disability Organizing Network will host a virtual technical support session and will be available for one-on-one technical assistance. Please share any access needs/accommodations that you will need to participate in the support session. 

NOTE: Zoom is the platform that will be used for the virtual technical support session. Zoom has a video, text, and call in option.

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* 6. Does your organization use social media?

Don't use social media? Don't worry! You can email photos & descriptions of your event or spotlight to allie@cfilc.org and Disability Organizing Network can still share your efforts.

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* 7. How will you participate?

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* 8. If you will host an in person event, drive or activity, please share the following information:

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* 9. If applicable, please share your social media handles (or you can paste links to your pages)

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* 10. By completely this form, we agree to be a partner with the Disability Organizing Network for 2019 National Voter Registration Week. This means: 

  • We will receive resources to support our social media spotlight(s) and/or in person event(s). 
  • We will have technical assistance available from July 8 - 12th.  
  • We agree to shout out/spotlight a local leader or organization is advancing voter accessibility, registration or engagement in your local community AND/OR
  • Host a local in person event, activity, or gathering; 
  • We agree to use the hashtag #DisabilityVoteCA on social media. 
  • We support Disability Organizing Network promoting our event and/or social media posts. 

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* 11. We agree to have Disability Organizing Network share our event or spotlight with REV UP so that our work can be made visible at the national level. 

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* 12. Additional comments or notes that you would like to add:

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